Health Insurance World

Humana brings dental coverage, network to New York

2011-05-21T06:39:00.001-07:00

A national insurer announced that it will offer dental benefits plans to people in New York, including New York City, Albany and Rochester, as part of its continuing dental plan expansion.

HumanaDental of Humana, headquartered in Louisville, Ky., will offer three plans to New York residents: Traditional Preferred, PPO and Preventative Plus plans.

These plans offer a variety of coverage and cost options. The Traditional Preferred and Preventative Plus plans provide members coverage for any dentist, while the PPO plan covers members’ visits to in-network dentists.

All three plans offer the option to cover 100% of costs for preventative services such as oral exams, and 50% to 100% of costs for basic services such as fillings.

Thanks to ifawebnews.

Health insurance companies invest billions in fast food chains

2011-05-21T06:38:00.000-07:00

Did you ever wonder how health insurance companies drum up future business? It's easy: Just invest in companies whose products cause chronic degenerative disease, driving people towards more health care needs and therefore more health insurance.

And that's exactly what the health insurance industry is doing. A new article published in the American Journal of Public Health reveals that U.S. and Canadian health insurance giants own nearly $2 billion worth of stock in fast food giants like McDonald's, Burger King, KFC, Taco Bell and others.

So profits made by health insurance companies are reinvested in industries that make people sick and diseased, bringing them back to buy more health insurance down the road. It's a pretty clever business model for an industry that seems focused on the almighty dollar and obviously has no concern whatsoever for the actual health status of its customers. If anything, these health insurance companies hope you get sicker!

Health Insurance Underwriting Guidelines

2011-05-21T06:36:00.002-07:00

One of the craziest things that has ever happened to me as a webmaster in health insurance happened when I started getting inundated with harassing phone calls and emails from the insurance companies for posting underwriting guidelines in my website. I don’t know why these documents are so secretive and guarded but I can say I was threatened with losing contracts and lawsuits if I didn’t pull them. As a result I caved in, sort of. I left the guidelines up but with no real way of navigating to them. The links were down in other words.

Most health insurance companies do not pay attention what I do over here so it seemed odd that I was getting ganged up on a daily basis during this period. What had happened was Blue Cross Blue Shield of Florida had found my postings and literally ratted me out to everyone. Usually, these companies would murder each other given a chance, but they were working together to protect their awful secrets.

Well, what has changed? Not a whole heck of a lot though we have grown both in size and stature in the industry and my blog (where you are reading this) is not really part of a commercial website so if you are wondering, I am going to republish at least a few of them. This blog doesn’t sell health insurance or make attempts to represent the carriers we work for in our professional lives so I am pretty sure it will fly unnoticed.

Why are these documents so carefully protected? I am not sure as it is not like most agents and carrier personnel don’t have easy access to them, but for some reason if they got into the hands of the general public who gets declined it could potentially be used in a lawsuit? I don’t know this is mostly conjecture.

California Health Insurance Exchange – Update

2011-05-21T06:36:00.000-07:00

Benefits cafe is writing...

I recently had the opportunity to hear Susan Kennedy speak at the Milken Institute Forum entitled: Federal Health Reform: Can It Achieve Its Goals?Susan Kennedy was Gov. Schwarzenegger’s chief of staff and she is his appointee to the board that will oversee the California Health Benefit Exchange. She was also deputy chief of staff for Gov. Gray Davis. Here is a link to a video of the California Health Insurance Exchange presentation.

I was very impressed with Ms. Kennedy. Anyone interested in the future of health insurance of California should watch the presentation. Hat’s off to the Milken Institute for putting on this event. The Milken Institute has an amazing ability to gather the people at the center of major public policy decisions and allow the public to watch, listen, and ask questions. All Californians and all Americans owe a huge debt of gratitude to the Milken Institute.

Health Reform Changes to Expect at Your Doctor's Office

2011-05-21T06:35:00.000-07:00

The authors highlighted a number of problems that exist: rates of readmissions, medication errors, and infections are much too high at nationwide hospitals. And American patients fail to take full advantage of preventive services like counseling for smoking cessation and screening for cancer. "Physicians will need to embrace rather than resist change," the study authors wrote, in order for the new legislation to successfully reverse these problems and reduce healthcare costs in the long term. That means doctors need to move away from a system where they're paid for ordering more tests and performing more procedures and toward one that reimburses them for coordinating care among a number of specialists and preventive health professionals like nutritionists and nurse practitioners. The goal is to keep you healthier and out of the hospital. Here's what you can expect at the doctor's office if not now, soon.
1) You'll get the healthcare you need—no more, no less.
2) You will receive healthcare from a team of health professionals.
3) Your care team will reach out to you in an attempt to prevent future health problems.
4) Technology will improve the efficiency of your healthcare.

New health insurance business model appears in Md. retail store

2011-05-21T06:34:00.000-07:00

A Baltimore insurance broker started an insurance retail store to provide consumers with direct access to insurance advice and enrollment in light of the health care reform law.

HealthPlan Headquarters (HPHQ), which opened in Overlea, Md., late last year, offers insurance in a retail location where clients can walk in and shop for insurance coverage. The store provides self-service kiosks and one-on-one consultations with insurance specialists. It also provides seminars on health and well-being, and educational seminars about insurance such as health care reform and Medicare.

“Our goal was to create an easily accessible and comfortable environment where everyday people can stop by and speak with licensed insurance specialists…about obtaining affordable health, life, disability, and property and casualty insurance,” Suzanne Thompson, founder and president of HPHQ, said on its website. A 24-year insurance vetaran, Thompson is a principal at Landmark Insurance and Financial Group in Timonium, Md.

Simple guide here.

Health insurance companies stockpiled billions in profits

2011-05-21T06:33:00.000-07:00

Nonprofit health insurance companies have been stockpiling billions of dollars in surpluses while raising members' rates, according to an analysis conducted by the nonprofit Consumers Union.

"Consumers are struggling to afford health coverage," report author Sondra Roberto said. "Those funds could be used in some cases to mitigate these rate increases."

Insurers are legally required to retain a minimum surplus in order to cover medical bills in the event of a financial downturn. Because no maximum surplus is set, however, many insurers have taken to amassing massive stockpiles.

To assess the degree of this problem, Consumers Union analyzed the surpluses of nonprofit Blue Cross and Blue Shield plans, which cover one in three privately insured U.S. residents. Surpluses ranged between two and seven times the minimum required.

Article from Natural new.

52 Million Uninsured Americans Due to Job Loss

2011-05-21T06:32:00.000-07:00

In US, working age adults who had health insurance through a job, became uninsured in the past two years because of losing the job, according to new health insurance survey. Once the law is fully implemented in 2014, nearly all of the 52 million currently uninsured American adults, including those who became uninsured during the recession, will have access to comprehensive health insurance coverage.

According to the report, Help on the Horizon: How the Recession Has Left Millions of Workers Without Health Insurance, and How Health Reform Will Bring Relief, the unemployed have great difficulty finding affordable health care. Only 25 percent of people who lost employer health insurance were able to find another source of health insurance coverage, and only 14 percent continued their job-based coverage through COBRA. In addition, purchasing individual coverage was not a viable option for most people. Seventy-one percent of adults who tried to buy individual coverage in the past three years, or 19 million people, either found it difficult or impossible to find a plan that fit their needs; found it difficult or impossible to find a plan they could afford; or were turned down or charged a higher price for coverage because of a pre-existing condition.

Kill Health Reform? not on their lives.

2011-05-21T06:31:00.000-07:00

There’s been a lot of controversy over whether the health reform law was worth the struggle and whether it should ultimately be repealed, but it’s plainly evident from my personal experience that some folks have benefitted from it already – and why some can’t wait for provisions to kick in three years from now.

In my personal situation, I never would have expected to consider the words “I have cancer” and “I am one lucky person” to go hand in hand – at least not until I got diagnosed last year, and started hearing horror stories from other survivors still waiting for relief.

There are many things related here.

Best Individual Health Insurance Policy - Keys to Pick

2011-05-21T05:35:00.000-07:00

Choosing the right health insurance coverage is hard enough with employer plans, but at least questions can be addressed to somebody on staff who knows more than you do and won't steer you to the most expensive plan. When you shop for coverage on your own, the choices are far more complicated. Most employers only offer one or two health plans as options. On the individual insurance market, you're likely to face dozens. And you're on your own.

Grappling with the details of so many different individual policies can lead to a strong urge to pick the next one that sounds halfway reasonable. But halfway isn't good enough. Hang in there, keeping the following eight basics in mind to help cut through the fog of numbers and unfamiliar terms:

1. Your "must-haves."
2. The cost of the basics
3. Provider networks
4. Out-of-pocket maximums
5. Prescriptions
6. Annual limits on coverage and services
7. Dependents
8. Getting help
Read in details.

Breast Cancer Patient Protection Act, H.R. 758 (110)

2011-05-21T05:33:00.000-07:00

Incidences of breast cancer are on the rise. According to the National Cancer Institute, 1 in 8 women will develop breast cancer in her lifetime. Twenty years ago, the risk was 1 in 11. In 2008 it was estimated that more than a quarter of a million American women will be newly diagnosed with breast cancer. It is the leading cause of cancer death for women between the ages of 20 and 59.

Today many women are forced to leave the hospital just hours after going through a painful mastectomy, the procedure that treats breast cancer by removing one or more of a woman's breasts. In instances often referred to as "drive-through mastectomies", many health insurance companies are refusing to provide coverage for a minimum stay, hoping to have the surgery administered as an outpatient procedure, despite the wishes of patients and their doctors.

The Breast Cancer Patient Protection Act would prohibit insurance providers from restricting benefits for any hospital length of stay to less than 48 hours for a mastectomy and 24 hours for a lymph node dissection. It does not require that the patient be in the hospital for the full 48 hours, only that the hospital stay be covered if deemed necessary by the patient's doctor. It also prohibits the insurance plan from requiring authorization from the doctor prior to the procedure and hospital stay.

Good to read more.

Next Term Life Challenge: Conversion Options

2011-05-21T05:32:00.000-07:00

The recession is bringing attention to an often-ignored policy feature in level term life policies—the conversion option.

Conversion provisions typically allow level term (LT) insureds to “convert” (shift into) a new permanent life policy within a specified number of policy years. The new permanent policy is priced for the client’s “attained” (current) age, but the insured doesn’t have to submit new evidence of insurability.

Many agents say the tough economy is spurring them to sell more LT policies than permanent. That’s often because the LT cost is much lower than that for the permanent plans (such as whole life and universal life with secondary guarantees) that would better suit the client’s situation.

Fore more news, please refer to life & health insurance news.

Health Care Reform

2011-05-21T05:31:00.001-07:00

After decades of failed attempts by a string of Democratic presidents and a year of bitter partisan combat, President Obama signed legislation on March 23, 2010, to overhaul the nation's health care system and guarantee access to medical insurance for tens of millions of Americans.

It was the largest single legislative achievement of his first two years in office, and the most controversial. Not a single Republican voted for the final version, and Republicans across the country campaigned on a promise to repeal the bill. After they took control of the House and expanded their ranks in the Senate in the November elections, action on health care was at the top of their agenda.

On Jan. 19, 2011, the House voted 245 to 189 in favor of repeal, in what both sides agreed was largely a symbolic act.

A few weeks later, Senate Democrats defeated a bid by Republicans to repeal the sweeping health care overhaul, as they successfully mounted a party-line defense. The vote was 47 to 51, with all Republicans voting unanimously for repeal but falling 13 votes short of the 60 needed to advance their proposal.

Without Health Insurance, Youth Gone Wild

2011-05-21T05:30:00.000-07:00

It should come as no surprise to most Americans that Generation Y (those youthful bastards under 30) are figuartively and literally dying for health reform as they are the most uninsured group in the country. (Other than minorities I would guess.)

The great researchers at Pew have come out with a new study that shows 33% of this group are not covered by any type of health insurance. 19% are not covered in my Generation (X), and baby boomers are at 12%. Those lucky seniors who are in the Silent Generation might be the last group to enjoy Social Security and Medicare as both programs are insolvent, and are 97% insured.

Of course these Millennials are allergic to news and due to their uninformed opinion making, they have not shown much support for health reform, on the other hand they do support Xbox and skateboarding. The group does favor the public option, but most are realistic and don’t expect health reform to fix their situation. If you ask a Millenial their opinion about health reform, make sure to first take out their ipod headphones so they can hear you, and then don’t be surprised when they have no idea what health reform is! Continue reading.

Best Affordable Health Insurance Options for Young Adults

2011-05-21T05:29:00.000-07:00

If you're young, cash-strapped, and healthy, health insurance might seem expensive and pointless. It's not. An ankle-twisting fall on a hiking trail, a broken arm in a friendly soccer game, bronchitis that turns into pneumonia—you're potentially talking thousands of dollars in medical expenses. Who do you think will get the bill? See which of the following eight categories describes you, and check out experts' recommendations. Our health insurance glossary will help with unfamiliar terms.

You're moving from high school into the workforce.
If your parents are covered through an employer, try to stay on their plan, says Kathleen Stoll, director of health policy at Families USA, a healthcare consumer advocacy group. It'll cost less than getting individual health insurance on your own. If you're under 26 and unmarried, you can be insured as a dependent on your parents' insurance (unless you can get your own job-based coverage). Some states require insurers to extend parental coverage to adult children past age 26; in New Jersey, for example, eligibilty lasts until you're 30. The Department of Health and Human Services (HHS) estimates that about 1.2 million young adults will elect to stay on a parent's health plan in 2011.
Find more.

Is buying individual dental insurance for a child’s orthodontia (braces) a good decision?

2011-05-21T05:26:00.000-07:00

Visit a dentist or orthodontist with your young child and be told that braces are needed leads one to the question: Should I buy an individual California dental insurance plan to cover the cost of braces for my child? This article addresses this question by examining the cost and benefits of two separate individual PPO dental plans. We’ve found that most people have a strong allegiance to their personal dentist and the orthodontist referred by the dentist. PPO dental plans are the most likely to include your dentist so we’ve focused on the PPO plans.

By way of back ground; individual HMO dental plans require a fixed copayment by the member for child orthodontia. For example, the Anthem Blue Cross Select Net Dental HMO plan requires the member to pay $2,870 for child orthodontia. The monthly premium in Los Angeles County for a child on this plan is $17/month or $204/year. Blue Shield of California does not offer a child-only dental HMO plan in Los Angeles. Delta Dental offers two individual policies for children: CAA55 costs $7/month, $84/year and has an ortho copayment of $2900; CAA54 costs $8/month, $96/year and has an ortho copayment of $2800. The information is current as of May 2011.